October 2013

Your Partners in Understanding Healthcare Reform
Providing Clear and Creative Health Insurance Solutions

CRITICAL INFORMATION REGARDING THE AFFORDABLE CARE ACT AND HOW IT WILL AFFECT YOUR CURRENT INDIVIDUAL POLICIES
 

 

Lynn Caffrey, Principal, CA License 0557451

Gabriel Caffrey, Broker, CA License 0H66348

Agency CA License 0G80281

About Caffrey Insurance Solutions
Caffrey Insurance Solutions
Phone: 510-444-5447
Fax: 866.530.7365 
Medicare ABC's

It's time for clients to make Medicare changes again. The current open enrollment period runs from October 15 through December 7. During this time, you may enroll in or change a Medicare Advantage plan. These are HMO type programs, the most common of which are Kaiser Senior Advantage, United Healthcare Secure Horizons and Humana. We are currently licensed to sell United Healthcare Advantage plans and we're working on Humana.

You may also change your Part D Prescription Drug Plan. 

Even if you're satisfied with your current Medicare, this is a good time to check to make sure of your costs and coverage for 2014. These can be easily checked on www.Medicare.gov. 

If you'd like us to check for you, please e-mail a list of your medications, dosages and frequencies.

This is not open enrollment for those on Medicare Supplement plans, but in California you may switch to an equal or lesser plan during the month following your birthday. It is always a good idea to check in and see if we can find you something better.

That Procedure Costs How Much?

A massive federal database of national health care costs was made public a little while back, according to an article in the Huffington Post.  

Are You Eligible for a Subsidy Through Covered California? Find Out!

The Covered California website is up and running at:

www.coveredca.com 

You can go online and see if you're eligible for a subsidy, and what you might expect to pay for one of the available plans. 

This will help us aid you in deciding the best way to go. If you are not eligible for a subsidy, you might as well buy off the exchange as the application process will be much easier than it is now, the networks may be stronger and the rates for mirrored (same as the exchange) plans will be identical. Also, not all carriers are represented in the exchange. 

At any rate, remember to use us before signing up for the plan you have for this next year. We are Covered California Certified Insurance Agents.

We will also be working in our customary capacity moving forward, assisting our clients with the whole process whether in Covered California or the private marketplace.

We take our responsibilities in servicing your policies very seriously and hope to continue to assist you with these new options as well. As always, our services are entirely free to you.

Best Broker in the  

East Bay

Lynn had the honor of being named Best Health Insurance Broker in the East Bay Express Best of the Bay awards. 

 

The review said that she was "an extremely dedicated full service health-insurance broker".  We work hard for our clients.

Review us on Yelp!

Yelp Page

 

Thanks to your great reviews, we have a five star rating on Yelp. If you have received good service from Caffrey Insurance Solutions over the years, please drop by and let prospective customers know about your experience. We really appreciate your time! Thank you.

How Long Will You Live?
This easy and fun calculator estimates your life expectancy.
  
It was developed by Northwestern Mutual Life, and it tries to predict how long you're likely to live. 

 

The predictions aren't going to be close if you do have a long-term health issue, but generally it works well. Barring long-term health problems, we are going to live a long time, most was into our late 80s or 90s.

As You Grow, We Grow With You

Please ask about additional services and value-added products such as HR administration and online policy management tools. 

Testimonials

"Lynn really helped me in dealing with a declined insurance claim by guiding me through the appeal process and communicating with the insurance provider. She offered continued support until the claim was reviewed and finally resolved. I truly believe that Caffrey Insurance Solutions' dedication in providing insurance as well as exceptional care and support to clients is invaluable."  --Current Individual Client

"Caffrey Insurance Solutions walked us through every state and step of a quite complex system, and we were successful! Without their help I do not believe we would have managed...I would refer anyone with insurance questions to Caffrey Insurance Solutions, and to Lynn Caffrey in particular."    --Alan B.

"Your expert advice is always appreciated. I literally don't know what I would do without you. You give me the most valuable gift of all: time."    --Scott Gordon 

 

"I'm glad there are individuals like Gabriel who can break it down so the average joe can understand the ins and outs of each plan, and make better-informed decisions."
     --Kerwin K.

"You are different from any image I have had of an insurance broker. I simply enjoy being with you. I experience a combination of efficiency, care, honesty, commitment and flexibility. I couldn't ask for better.               --Miki Kashtan


Lynn and Gabe profile picture
The material is very important and timely. We are now Covered California Certified Insurance Agents in addition to all of our traditional roles, and we are here to help you.
 
Individual plans will be automatically transitioned to Affordable Care Act compliant plans. Your benefits will change, as may access to your providers. Your carrier will notify you of these changes shortly.
 
Much of the information in this dispatch will not apply to clients who participate in grandfathered individual or group medical plan.
 
The open enrollment period for new ACA compliant individual and family plans runs from October 1st, 2013 through March 31, 2014. If you don't enroll in a plan during this time frame you will not be able to enroll until the next open enrollment session running October 15th, 2014 to December 7th, 2014 unless you have a qualifying event.

Don't Panic!

Please do not panic about getting on a new health plan for 2014. 

 

Whatever you do, it is best not to do it entirely on your own, even though it might be tempting to just get it done. The cost is the same either way, and we want to continue our working relationship with you.

 

You have until December 15th to submit application for coverage effective January 1st 2014, and until March 31st 2014 to complete the current open enrollment period. 

 

You can not get guaranteed coverage if you apply outside the open enrollment period except in the case of certain qualifying events. The next open enrollment opportunity after this one does not begin until October 15, 2014.

 

We know the latest facts and are here to help you. If you go directly to the carriers or to Covered California, you will not have an agent to assist you if you have any problems now or in future. 

 

We are expanding our staff during this busy period to make sure we can get people enrolled in a timely basis. Please feel free to make an appointment for an enrollment or consultation, to see what your options may be moving forward.

 

If you have spoken with us regarding a Covered California plan in the last couple of weeks and we have not yet gotten back to you, please call in so that we can finalize your enrollments. 

Do You Want To Touch Base?

Lynn Caffrey We're asking all of our clients to schedule meetings (telephone, in person or via email) through our online appointment booking tool. 

This allows us to properly allocate enough time to address any concerns you may have regarding your benefits and to finish the new more time-intensive enrollment process for individual and family coverage.

What Would Your Agent Do?

Q: I have been told my Aetna plan will end on December 31, 2013. What do I do?

 

A) Find a job with an employer-sponsored group plan

B) Apply for an individual plan now so that it will be in place by January 1, 2014

C) Join my spouse's a group plan

D) Freak out and curse a lot

E) None of the above

 

A: This scenario is happening to most of our individual and family plan clients, with all major carriers, not just Aetna. Unless your plan is grandfathered (purchased before March 23, 2010), your current plan design will be terminated. 

 

In most instances, your carrier will map you to another plan, but it will be nothing like your current plan and it could cost less, or even much more. 

 

If you contact us, and please do, we can advise you on your options. You may be eligible for a subsidy which could save you thousands of dollars per year, or you could do better by moving to another carrier to keep access to your current practitioners.

Items You Will Need to Complete Your Application

Lynn Caffrey The initial part of the process of applying for a plan through Covered California involves creating a personal account on their website, which we then connect to as your agent to assist you in the final plan selection and discussion.

 

You can begin application for your own profile yourself if you wish to, although we are also glad to walk through this with you either in person, via telephone, or even via screen sharing session so that we can help you get this done wherever you happen to be.

 

Covered CA Online Account Requirements:

  • User ID: Minimum 8 characters
  • Password: Minimum 8 characters, letters and numbers only
  • PIN: Four digits
  • Security Questions: 5 total, to be selected from question bank

We do not need to see this information, although it is important for you to keep it handy or memorize it in order to be able to go back in and make any adjustments to your account as your circumstances change. The account is your personal account with Covered California and is used to report any changes in your situation over time.

 

Covered CA Income Documentation Recommendations

(to determine subsidy based on estimated 2014 earnings):

  • Your most recent tax return
  • Any other data regarding recent employment or expected income
  • If self-employed, a detailed list of any deductions you may take to cover business expenses
  • A scan of your current driver's license or passport

The numbers Covered California asks for are based on 2014 expected income, but accuracy is quite important as if you fall below a certain threshold you will automatically be registered for Medi-Cal, which many of our clients do not want to happen.

Alert! 

If You Are Currently Without Coverage, A Temporary Policy May Be The Answer

We are close enough now to January 2014 that a temporary policy may provide a good solution for your insurance needs. Although temporary plans are not guaranteed issue, the underwriting process comparatively simple and may meet your needs well until a plan can be issued through Covered California or the private individual and family market for January 1. 

 

In most cases temporary medical coverage can be effective the day after you apply! (Important caveat: they do not cover presciption medications.) 

 

Ask us if you want some options if this scenario applies to you. Or if you prefer, you can try the direct application linked here, which will assign us as your broker of record and save you some time. We will service any policies applied for this way.

New Census Form For Group Plan Quoting

Upon request, we will be re-marketing all of our small group clients to see if new ACA compliant group plans are the best option available to you. In order for us to calculate your rates prior to the deadline for your particular carrier, please send this in at least two weeks before that. You should have received notice of this deadline already but if you have not let us know.

 

In general, we and the carriers are recommending that you take advantage of a December 1st anniversary to maintain your plans and networks for another year. Many of you have already done or will be doing this.

 

Please fill out the linked census form and return to us at your earliest convenience so we can quote options that will continue to serve you well next year. 

For Those Groups Considering Dropping Group Coverage

Even if you are giving some thought to dropping group coverage altogether when the Affordable Care Act takes full effect in January, we do want you to provide us an up to date formatted census, detailed in the census section above. We will do a comparison for you as soon as we have all of the rates and plan designs that will affect you.

 

It's important for you to remember that you are not permitted to pay for private individual policies either through Covered California or on the standard individual and family marketplace as a company benefit.

 

Please do bear in mind that everyone in the insurance industry, from your broker to the carriers to the underwriters to the practitioners, is taking a hit on their income. We expect to need to write about twice as much individual and group business to stay on an even keel, and we appreciate your continued trust and faith in our services during this transitional time.

Insurance Carriers Announced for Covered California 

and 

Small Business Health Options Program (SHOP)

Small Business Health Options Program (SHOP) Carriers

  • Blue Shield of CA
  • Chinese Community Health Plan
  • Health Net
  • Kaiser Permanente
  • Sharp Health Plan
  • Western Health Advantage

 

Covered California Individual and Family Plan Carriers (Northern California)

  • Alameda Alliance for Health
  • Anthem Blue Cross of California
  • Blue Shield of California
  • Chinese Community Health Plan
  • Contra Costa Health Care Plan
  • Health Net of California
  • Western Health Advantage
For more information please visit www.coveredca.com. We are Covered California Certified Insurance Agents and can assist with enrollments, quoting and service. 

About Caffrey Insurance Solutions 

Caffrey Insurance Solutions is a family business employee benefits brokerage firm that provides insurance expertise for small companies (fewer than 50 employees) and individuals seeking individual or family coverage. We also provide Medicare assistance.  

Caffrey Insurance works with you to find the best insurance benefits that provide the best value, tailored to the unique needs of your company.
 

California License Information
Lynn Caffrey: 0557451
Gabriel Caffrey: 0H66348
Caffrey Insurance Solutions, Inc.: 0G80281

Caffrey Insurance Solutions, Inc.
405 14th Street, Suite 711
Oakland, CA 94612
Phone: 510-444-5447
Email: [email protected]